Tuberculosis hospita Pi'a
Hospital and Sanatorium
Construction WRITTEN FOR
THE NATIONAL ASSOCIATION FOR THE STUDY AND PREVENTION OF TUBERCULOSIS
THOMAS SPEES CARRINGTON,
NEW YORK 105
EAST TWENTY-SECOND STREET 1911
Columbia ^ntoersiftp in tije Citp of ^cto ^orfe
CoUege of ^ft psiciang anb ^urgconsi
Adirondack Cottage Sanitarium, Trudeau, N. Y. The Original Oxe-roum Cuttage where \)R. Edward L. Trudeau began his Experiment with the Open-air Treatment OF Tuberculosis.
Tuberculosis Hospital and Sanatorium
Construction WRITTEN' FOR
THE NATIONAL ASSOCIATION FOR THE STUDY AND PREVENTION OF TUBERCULOSIS
THOMAS SPEES CARRINGTON,
NEW YORK 105
EAST TWENTY-SECOND STREET 1911
Preface The present work
an expansion of the pamphlet issued two years ago by
the National Association for the Study and Prevention of Tuberculosis in response
to a pressing
in the establishment of sanatoria
During this period the emphasis of the campaign has been laid particularly upon the importance of increasing our equipment for the institutional care of tuberculous patients.
The response has exceeded expectation and has been
ticularly encouraging in the degree to
accepted responsibility for the situation.
true that institutional expense
tenance than of original cost of construction
to care for the largest possible
of patients at the lowest possible cost compatible
Under these conditions the problem
tuberculosis from the institutional point of view
a matter of main-
equally true that careful prelim-
is the chief factor in subsequent economy of operation. It is with end in view that the following study has been prepared. It is hoped that the book will prove of service to those charged with the
inary planning this
responsibility of dealing with the institutional
in their several
Executive Secretary. ijth, igii
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Transportation Facilities; Extent and Nature of the Land; Lighting, Water and Sewage; Meterological Conditions; Natural Beauty; Examination of the Land; Farm Buildings; Grouping; Cleaning and Apportioning Grounds; Railroad Station; Buildings and Improvements for Block Plan; Sites for Hospitals to House Advanced Cases; Examples of Grouping and Sites.
Methods of Sanatorium Administration; Planning Administration Buildings; Class and Number of Patients; Staff and Servants' Housing; Staff and Servants' Salaries; Service Buildings; Amusement Pavilions; Industrial Buildings; Water Supplies; Light, Heat and Power; Laundries; Sterilizing Rooms; Vacuum Cleaning Plants; Ice Houses and Cold Storage Plants; Carpenter and Paint Shops; Store Houses, Bakeries and Scale Houses; Green Houses, Forcing Beds, Vegetable Cellars; Garages, Barns and Stables; Farm Outfits; Cow-barns; Silos; Milk Houses; Chicken and Hog Houses; Sewage Disposal Plants; Examples of Administration Buildings; Examples of Service Buildings.
Administration Buildings and Patients' Quarters Combined
Suggestions for Planning Buildings; Examples of Complete Institutions under One Roof.
Hospitals for Hospitals
Description of Hospitals for Advanced Cases; Description of Infirmaries; Description of Reception Hospitals; Examples of the Buildings at Various Institutions.
Lean-to Type of Building
Origin of These Buildings; Material; Finish; Excavation; Exposure; Arrangement of Floor Plans; Porch Space; Porch Protection; Ventilation; Fixtures; Plumbing; Examples of Lean-tos.
Cottage Type of Building.
Origin of These Buildings; Points to be Considered in Designing Cottages; Examples of Cottages.
Trudeau's Original Cottage.
Site and Grouping
Loomis Sanatorium, Liberty, N. Y., V^iews of a Farmhouse before and after Remodeling Views of Land Showing Natural Features of Value on Sites for Sanatoria
Mar>'land State Sanatorium, Sabillasville,
Bird's-eye View Georgia State Sanatorium, Alto, Ga.,
Waverly HiU Sanatorium, Waverly Hill, Ky., Front Elevation and Block Plan Agnes Memorial Sanatorium, Denver, Colo., Front Elevation and Block Plan
Indiana State Hospital, Rockville, Ind., Bird's-eye View and Block Plan Portland Open Air Sanatorium, Portland, Ore. Block Plan \'ermont State Sanatorium, Pittsford, Vt., View of Front Elevation and Block Plan Essex County Tuberculosis Hospital, Soho, N. J., View of Buildings and Block Plan Maine State Sanatorium, Hebron, Me., Block Plan Preventorium for Children, Farmingdale, N. J., Bird's-eye View of Building and Block Plan
Adirondack Cottage Sanitarium, Saranac Lake, N. Y., Amusement Pavilion; Views and Plans. Municipal Sanatorium, Otisville, N. Y.,
Portland Open Air Sanatorium, Portland, Ore.,
..... ........ ...... ......
Servants' Open Air Sleeping Pavilion Air Dining Room
Amusement Pavilion; Interior Catawba Sanatorium, Catawba, Va., A Method of Storing Water. Waverly Hill Sanatorium, Waverly Hill, Ky., View from Rear of Buildings Showing Power House Preventorium
Farmingdale, N. J., Power House and Laundry; Elevations and Floor Plans District Tuberculosis Hospital, Lima, Ohio, Floor Plan of Basement Showing Arrangement of Power Plant A Rectangular Steam Disinfecting Chamber
Eudowood Sanatorium, Tow.son, Md.,
40 41 42 43
Administration Building; View and Floor Plans Maine State Sanatorium, Hebron, Me., Administration Building; View and Floor Plans Iowa State Sanatorium, Oakdale, la., .\dministralion Building; View and Floor Plans Manitoba Sanatorium, Ninette, Manitoba, Canada, Administration Building; Views and Floor Plans
Indiana State Hospital, Rockville, Ind.,
-Administration Building; View and Floor Plans Preventorium for Children, Farmingdale, N. J., .Administration Building; Elevation and Floor Plans
48 5° 55
Illustrations No. 28 29
Otisville, N. Y., Service Building; View and Floor Plans Iowa State Sanatorium, Oakdale, la., Service Building; Views and Floor Plans Catawba Sanatorium, Catawba, Va., Service Building; Elevation and Floor Plan New Haven County State Sanatorium, Meriden, Conn., Service Building; View and Floor Plans
Administration Buildings and Patients' Quarters Combined 32 ^^
Eastern Maine Hospital, Bangor, Me.,
Method of Protecting Sleeping Porch with Wire Netting Hospital for Insane, Washington, D. C, Method of Enclosing Porch, with Swinging Sash Frames Sharon Sanatorium, Sharon, Mass., View and Floor Plan Tuberculosis Hospital, Washington, D. C, View of Front Elevation Tuberculosis Hospital, Washington, D. C, Floor Plans Lady Grey Hospital, Ottawa, Canada, View and Floor Plans Lake Edward Sanatorium, Lake Edward, Quebec, Canada, View and Floor Plans Franklin County Tuberculosis Hospital, Columbus, Ohio, Elevation and Floor Plans Hartford County Tuberculosis Sanatorium, Hartford, Conn., View and Floor Plans Cuenca Sanatorium, -Bass Lake, Minn., Elevation and Floor Plans Association Sanatorium, Colorado Springs, Colo., Elevation and Floor Plans District Tuberculosis Hospital, Lima, Ohio, Views and Floor Plan A Design for a Small Town or Village Hospital, Elevation and Floor Plan U.
...... ..... ... ...... ...... ..... ...... .
...... ..... .
SECTION IV Hospitals for Advanced Cases 45
and Reception Hospitals
Reception Hospitals, and
of the Floor Plans of Infirmaries,
Buildings Housing Advanced Cases Indiana State Hospital, Rockville, Ind., A Method of Connecting Rooms with Open Porches Isolation Hospital, Paterson, N. J., A Method of Heating Porches for Advanced Cases .
48 49 50 51
Concrete Pavilion; Elevation and Floor Plans Jewish Hospital for Consumptives, Reisterstown, Md., Pavilion for Advanced Cases; Views of Elevations Jewish Hospital for Consumptives, Reisterstown, Md., Pavilion for Advanced Cases; Floor Plans Indiana State Hospital, Rockville, Ind., Pavilion for Advanced Cases; View and Floor Plans Isolation Hospital, Paterson, N. J., Pavilion for Advanced Cases; View and Floor Plans United States Army General Hospital, Ft. Bayard, N. M., Officers' Quarters; View and Floor Plan United States Army General Hospital, Ft. Bayard, N. M., Enlisted Men's Ward No. 2; View and Floor Plan. United States Army General Hospital, Ft. Bayard, N. M., Enlisted Men's Ward No. 2; View of Inner Court Lakeville Tuberculosis Hospital, Middleboro, Mass., Pavilion for Advanced Cases; View and Floor Plan Boston Consumptives Hospital, Mattapan, Mass., Ward for Advanced Cases; View and Floor Plan Maine State Sanatorium, Hebron, Me., Infirmary; View and Floor Plan
Municiijal Sanatorium. Otis\ille. X. Y., Infirmary; \'ie\vs of Front and Rear Elevations Municijial Sanatorium, Otis\ille, N. Y., Inhrmar}-; Floor Plans
Eudowoocl Sanatorium, Towson, Md., Infirmary; \'ie\vs and Floor Plan Edward Sanatorium. Xaperville, 111., Infirmary and ^Medical Building; View and Floor Plans Adirondack Cottage Sanitarium, Saranac Lake, N. Y., Infirmary and ^Medical Building; View and Floor Plans Mar\-land State Sanatorium, Sabillasville, Md., Infirmary; Mew and Floor Plans
Georgia State Sanatorium, Alto, Ga., Infirmary; View and Floor Plan
Danvers State Hospital, Hawthorne, 2\Iass., Paxilion; \'iew of Elevation and Floor Plan Ohio State Sanatorium, Mt. Vernon, Ohio, Reception Hospital; View and Floor Plan
SECTION V P.\TIENTS' Qu.^RTERS
68 69 70 71
TyPE OF BuiLDING FOR INCIPIENT
86 87 88
Loomis Sanatorium, Liberty, N. Y., Open Porch, Showing a Method of Interior Finish Loomis Sanatorium, Liberty, N. Y., Lean-to; View and Floor Plan Michigan State Sanatorium, Howell, Mich., Lean-to; View and Floor Plan Marjdand State Sanatorium, Sabillasville, Md., Lean-to; View, Cross-Section and Floor Plan Delaware State Sanatorium, Wilmington, Dela., Lean-to; \'iew and Floor Plan Ohio State Sanatorium, Mt. Vernon, Ohio, Lean-to; View and Floor Plan
Georgia State Sanatorium, Alto, Ga., Design for a Lean-to New Haven County State Sanatorium, Meriden, Conn., Lean-to; View and Floor Plans Catawba Sanatorium, Catawba, Va., Lean-to; View and Floor Plan Manitoba Sanatorium, Ninette, Manitoba, Canada, Lean-to; \'iew and Floor Plan Edward Sanatorium, Napen,ille, 111., Lean-to; View and Floor Plan Eudowood Sanatorium, Towson, Md., Lean-to; \'iew and Floor Plans Iowa State Sanatorium, Oakdale, la.. Lean-to; \'iew and Floor Plan Municipal Sanatorium, Otisville, X. Y., Lean-to; View and Floor Plan Association Sanatorium, Louisville, Ky., Lean-to; View and Floor Plan North Reading State Sanatorium, North Reading, Mass., Lean-to; View, Cross-Section and Floor Plan Edward Sanatorium, Naperville, 111., Lean-to; \'iew and Floor Plan .
....... ........ ........ .
........ ........ ..... ........ ........ .......... ........ ........ ........ ........ ........ ........ ........ .
Comparison of Floor Plans of the Lean-to Type of Buildings for Housing Incipient Cases Catawba Sanatorium, Catawba, Va., An Open Porch Illustrating Simplicity of Construction North Reading State Sanatorium, North Reading, Mass., An Open Porch Illustrating a Method of Protection Mrginia State Farm, Richmond, Va.,
Open Porch, 72
Iowa State Hospital, Mt. Pleasant, la.. Lean-to; Elevation and Floor Plan Rush Hospital, Country Branch, Malvern, Lean-to; View and Floor Plans Loomis Sanatorium, Liberty, N. Y.^ Lean-to; Mew and Floor Plan
Illustrations No. 92
Michigan State Sanatorium, Howell, Mich., Design for a Lean-to New Yorlv State Hospital, Raybrook, N. Y., Design for a Lean-to ISIunicipal Sanatorium, Otisville, N. Y., Lean-to; View and Floor Plans Preventorium for Children, Farmingdale, N. Lean-to; Elevation and Floor Plans
SECTION VI Patients' Quarters 96 97
Type of Building
Millet Sanatorium, East Bridgewater, Mass., Cottage; View, Cross-Sections and Plans Rush Hospital, Country Branch, Malvern, Pa., Cottage View and Floor Plan Adirondack Cottage Sanitarium, Saranac Lake, N. Y. ;
99 100 loi
Cottage; View and Floor Plan Association Sanatorium, Louisville, Ky., Cottage; View and Floor Plan
White Haven Sanatorium, White Haven, Pa., Cottage; View and Floor Plan Municipal Sanatorium, Otisville, N. Y. Cottage; View and Floor Plan Plainfield General Hospital, Plainfleld, N. J., Cottage; View and Floor Plan Iowa State Sanatorium, Oakdale, la., Cottage; View and Floor Plan Adirondack Cottage Sanitarium, Saranac Lake, N. Y., Wheeler Cottage; View and Floor Plan Gaylord Farm, Wallingford, Conn., Connected Cottages; View and Floor Plans Barlow Sanatorium, Los Angeles, Cal., Cottage; View and Floor Plan .
Portland Open Air Sanatorium, Portland, Ore., Cottage; Views Loomis Sanatorium, Liberty, N. Y., Orchard Cottage; View and Floor Plan Adirondack Cottage Sanitarium, Saranac Lake, N. Y;, Nathan Cottage; View and Floor Plan, River Pines Sanatorium, Stevens Point, Wis., Cottage; View and Floor Plan
160 162 .
Introduction hoped that
be found useful by those
desire to design
construct hospital and sanatorium buildings for the care of tuberculous patients.
The information presented has been
collected during a series of investigations into
the methods and materials used in the construction of buildings at various institutions
This book all varieties and stages of tuberculous disease. and expansion of the original pamphlet on construction, "Some Plans and Suggestions for Housing Consumptives," published in 1909 by the National Association for the Study and Prevention of Tuberculosis, and includes the results of studies made on the question of sites, in order to determine in some degree the effect of location and During the past surroundings from both the cUnical and economic points of view.
where patients are treated for
two years, in a number
of states, legislation
has been enacted authorizing counties to
establish institutions for the treatment of tuberculous patients.
movement has brought about many new problems and sanatoria, and
rapid growlh of this
and maintenance work such material
in the construction
has been the aim to
in the solution of these difficulties.
Cost of Construction It is the opinion of the majority of those who have had experience in constructing and administering tuberculosis hospitals and sanatoria, that it is wise to build in a comparatively inexpensive manner. Excellent results have been obtained by the open-air method of treating tuberculous patients in institutions built on simple and economical plans; and further, this class of institutions returns patients to their homes without making them unduly discontented with the environment and life to which they belong. It may therefore Ije said that those who adhere to simplicity and economy in sanatorium construction and furnishing, and who supply patients with good wholesome food, cleanliness, light employment, and a happy, friendly atmosphere, are operating along modern and approved lines.
of the first questions
incipient cases or a hospital for
asked when the establishment
of either a
proposed in a community,
be needed for constructing and maintaining the institution?"
In general terms
for Incipient Cases,
having a capacity
of fifty patients, will cost to
build and ef|uip (exclusive of the land) $25,000 and upward.
A Hospital for Advanced Cases, having a capacity of fifty patients, will cost to and equip (exclusive of land) $50,000 and u})ward. A Hos[)ital for Both Classes of Cases, having a capacity of fifty patients, will cost build and equip (exclusi\-e of land) $35,000 and upward.
In other words,
will cost to
complete institution for Incipient
Cases about $500 per bed; for Advanced Cases $1,000 per bed; and for Both Classes of
$750 per bed. 14
Introduction Cost of Administration Buildings Administration buildings for an institution housing
patients can be constructed
and upward, the cost depending upon the material used and the
Cost of Infirmaries and Pavilions for Advanced Cases Infirmaries and pavilions for advanced cases, having a capacity of twenty patients
can be constructed for $10,000 and upward.
in single rooms,
Cost of Lean-tos Lean-tos having a capacity of sixteen incipient cases can be constructed for $800
Examples The expended
of Appropriations following
given in order to show how, in an actual case, $100,000 was
for the construction of a State
of all classes except the
Sanatorium housing one hundred and
Administration Building Four Lean-tos (each $3,500) Two Wards for Advanced Cases (each $7,000) Power House and Heating Plant Sewage Disposal Plant Water Pumping and Supply Plant
3,300 7,000 1,200
$31,500 14,000 14,000 5, 000
very far advanced cases.
is cited in order to show the distribution of an appropriation for the County Hospital having a capacity for fifty patients, of all classes.
construction of a
Site, Water Supply and Sewage Disposal Administration Building Advanced Case Pavilion (Twenty Beds) Two Incipient Case Pavilions ($2,500 each)
of the Floor
$10,000 16,000 10,000 5, 000 $41,000
Plans for Administration Buildings
Administration Buildings constructed for Tuberculosis Hospitals or Sanatoria
have been designed on general hospital
This has not proven to be the most
factory type of building for administrative purposes, as the medical
vants are often arrested or cured cases of tuberculosis.
nurses and ser-
Administration buildings that
seem best adapted for institutions of this class, are those constructed so that all persons housed in them may have, if desired, individual open-air sleeping porches. For this reason, it is
the opinion of
open type; that
buildings for tuberculosis institutions should be
to say, with walls pierced
floors to the ceiling as possible,
reaching from the
apartments arranged so that they 15
Introduction open on at
dining and sitting rooms, which are
constructed as small individual buildings, and arranged to be opened on
weather permits, are being erected in greater numbers, and prove satisfactory. used by the adniinistrati\'e departments, except in are said to gi\-e better ser\'ice sites are large
towns where land
from the patients' quarters.
enough, one-story buildings, even for administrative purposes, are becoming
Plans for Pavilions for Advanced Cases
Paxdlions for advanced tuberculous cases have also, in the past, been constructed in the
as general hospital wards,
has been found that
tuberculous patients, with proper care, quickly improve under the open-air treatment, these buildings are
now being planned
rooms pro^'ided of Floor
open porch space
for all far
Plans for Lean-tos
The only changes
importance, during the past months,
in designing the
and on the open sleeping porches in order to house the patients in smaller groups. It may be said that practically all new designs call for lockers which are large enough to be used as private dressing rooms, and in many instances fitted with a chest of drawers, a mirror, racks for toilet articles, and other conveniences.
lean-to t}^e of building, have been in the pro\dsion of larger lockers for each patient, in placing transverse partitions
the cost of maintaining an institution after
and planning the buildings. Transportation expense is one of the larger factors in this problem, and it is becoming clearer that public institutions must be placed on or near good transportation faciUties. In a number of instances, railroad companies have ^\illingly put in spurs or sidings free of charge, as the sites chosen were near their right-of-way, and it is advisable that authorities, considering erected, should be always before those selecting the site
the establishment of a sanatorium or hospital, consider this question with care before pur-
chasing an otherwise desirable property.
Sanatorium Sites site in the open country for a tuberculosis sanatorium, to house inand moderately advanced cases, a decision must be made as to whether the ad\'antage of having the patients near at hand and accessible to their friends overweighs the possible benetit to be obtained by placing the institution in a region more favorable from a
In selecting a
climatic point of view, but far from the patients' homes. in the
generally agreed that
treatment of tuberculosis excellent results can be obtained in practically any section
of the country
and the desirability of local Within a short distance
obtained where tuberculous patients
institutional provision can be accepted as of
almost every city and town, land can be
Transportation Facilities Transportation
should always be carefully considered, as a long haul from
the railroad or landing adds expense both in building and maintenance.
near future most of the institutions founded with the intention of housing over one hundred patients, will be placed
upon land that can be reached without great expense by a private
branch or spur from the nearest railroad, or by some other means of public transportation.
on a direct
It is often
very desirable in order to make
hard to hold consumptives
like to leave their families,
of the patients are
accessible to the patients'
sanatorium, for the very sick do not
and many incipient patients become
pelled to drop their regular occupations.
drawn and where by
when first comtowns from which
close to the
a short trolley trip visitors can reach
help very largely in making the patients contented.
Extent and Nature of the Land
The it will
should be a tract of land from twenty to two hundred acres in extent and
be more valuable for
are supplied with efficient
includes forest, orchard
and land that can be
generally conceded that incipient patients improve faster
medical superintendent, they
when they by an
be able to do a considerable part of the farm work
with real benefit to themselves and a reduction in the cost of their maintenance. there
a choice of a
land when selected
while the natural advantages of another property
tion of possible land
number of sites, a damp or swampy location should be avoided, as such must be drained. The expense of preparing some land is very great,
For these reasons
chosen as a
be such that a large outlay for im-
advisable to have a thorough examina-
Water and Sewage
A good supply of water is is
for this reason
building near a city
possible, to secure property within the line of the city water supply
systems, thus settling the question of water, sewage disposal and lights.
and sewer other land
considered there should be good springs, a running stream of clear water, or the possibility of obtaining it
thoroughly protected well.
be considered before the land
disposal of sewage
acquired, as the quality of the
the rise of the land and
and lakes enter into the question and increase or reduce the and maintenance. These subjects are all considered more in detail under the section on administration buildings. the position of water courses
cost of installation
Meteorological Conditions very important that the meteorological conditions
of a prospective site should This means obtaining data with regard to the altitude, average humidity,
number of stormy days in the year, highest and lowest degrees of heat and cold, prevailing winds and an}' atmospheric peculiarities which might affect either the patients or building materials. It is v:e\l to remember that vastly differing conditions are often found within a radius of a few miles;
therefore, such information should be gathered on the site itself.
strong winds prevail during certain seasons of the year and where hea\y frosts
occur more frequently during the winters than in other nearby localities should be avoided if
L^sually the southern exposure of a hill or
to be preferred.
Natural Beauty year,
The problem of holding tuberculous patients at sanatoria grows more serious each and as the institutional care of certain classes of cases seems to be an absolute necessity
in order to control the disease,
made to place patients upon sites amuse and make them contented. The
every effort should be
that have natural attractions which will help to
open country, where a sanatorium for incipient cases is generally placed, usually offers a In making a decision from choice of sites some of which may have great natural beauty. several pieces of property offered, this should be considered as a valuable asset. A sloping, rolling or hilly piece of
a lack of
desirable than a level one.
and a forest, lake or stream gives opportunities for A great deal can be done by artificially improving the grounds where there natural beauty, and in the selection of a site in a bare or flat country this should
and trees add amusement.
of the view,
by the National Association for the Study and Prevenneeded by its Bureau of Hospital and Sanatorium Construction, may be of some assistance to those examining a property for the purpose of determining its value as a site for hospital and sanatorium purposes.
following questions used
tion of Tuberculosis
acres of land are available for Sanatorium purposes? flat, roUing, or on a hillside? What is the degree and exposure of the slope of the hills? Are there trees for protection from prevailing winds? What is the direction of the prevailing winds in summer? In winter? Is the
the altitude above sea level and above surrounding country? the amount of moisture precipitation per year? 19
No. I.— Loomis Sanatorium, Liberty, N. Y. Views of a Farm-house before and after Remodeling. XoTi: the Wide Sleepim; I'orc hks Constructed on the Front of the Building in the Lower Illustrxtiox. ('See illustrations 72, 73,91 and 108 for further description of this institution.)
What What What What
the average amount and duration of snow? the highest and lowest recorded temperature? 10. is the mean temperature of the winter months? 1 1 is the mean temperature of the summer months? 12. Is it possible to use the local water supply of the nearest town? 13. At what height on the property above or below the building site is the water supply? 14. What is the amount of water flow in gallons per minute? 15. What is the direction and size of the water courses on the property? 16. What are the lighting facilities in the neighborhood, gas, electricity, etc.? 17. What is the composition of the soil? iS. What building materials are available on or near the propert}^? Can sand, building stone, rough stone for foundation, brick, cement, lime and timber be easily obtained? 19. What are the transportation facilities, such as railroad, trolley lines, etc.? 20. Where is the principal approach to the proposed site? 21. What is the distance from the nearest saw and planing mill? 22. Are there any old buildings on the site? (Give full description with a drawing of the floor plans and photographs of the front and side elevation.) Note: Sketch-map of proposed property showing location of buildings, entrances, water-courses, etc., is very desirable. 8. g.
Farm Buildings Often farm-houses or other structures stand on the land chosen and can be remodeled
so as to
useful sanatorium buildings.
be materially reduced
and unsanitary conditions corrected,
season of the year.
of constructing the institution
these are good, substantial structures, but they should be examined especially
the buildings are
Careful inspection of the plumbing, drains, and cellar should always be
made by an experienced
the walls of the cellars are damp,
should be used to obtain a circulation of air about the foundation.
This can be done by a
new wall built beside the old foundation, The cellar floor should then be relaid with a foundation of broken stone, covered with cement, and openings made in the cellar walls to procure plenty of light and air. The greatest care must be used to prevent dampness trench opened on the outside of the house, and a
leaving an air space between the two waJls.
old buildings; in
in others it
some places a
subsoil system of drainage will be needed, while
be necessary to remove trees close to the house.
In all rooms, where there is sufficient wall space, new windows should be made, and windows cut down to the floor and up to the ceiling. Ventilation for the winter months may be obtained by building fireplaces or installing ventilating flues, and other appliances used to give a continuous change of air. Often it will be necessary to install baths and toilets and have connections made with the water supply and sewage disposal plants. Many old farm-houses are built of heavy timbers which are usually well preserved and can be repaired and put in excellent condition without great expense. When planning a rearrangement of an old building for administration purposes, a large dining room is usually the most important apartment to be provided, and often can be made by removing the partitions between rooms on the ground floor and throwing two or three together. old
institutions ha^'e been started
by housing the administrative department in old room and office on the first
buildings which were only large enough for a kitchen, dining floor,
and a few rooms
for the staff
on the second.
hospital started in this
provide for a large number of patients.
old country mansion will often
a good administration centre for a small,
The Natural Features of the Land shown in These Views Greatly Add to the Value of Property for Sanatorium Sites. Tiik Group of Buildings in the Upper Illustration IS THE liARLOW SANATORIUM. (See a description of the cottages on page 159.)
Site private sanatorium, in
cases without remodeling.
Small cottages of the Millet
type (Illustration 96), or those of the Open air Sanatorium, Oregon (Illustration 107), can then be built about the grounds for a comparatively small outlay.
The barns and
save a considerable outlay,
for they can be used for housing cows, chickens and other domestic animals which should
be counted on to reduce the cost of maintenance.
Grouping There on the
of funds or energy.
a hospital or sanatorium after
information as to the best methods of arranging buildings
institutions in order that the plants It is to
the initial cost of construction.
started in a small way, additions being
and very little
be remembered that the economical operation of
when completed can be run without
existing sanatoria of large size were
haphazard manner as necessity required,
planning done except for administration buildings, power houses and patients'
quarters, before the construction of the plant
superintendents of a number of
was commenced. have found after
also a fact that the
to be ready for good work, that large additions to their buildings were necessary to reduce
In order to overcome this
the cost of maintenance to a defensible figure.
future, for projected institutions, a general block plan of the site should be
particularly true for public institutions depending for their
support upon the good will of the community which they are to serve, as in producing a symmetrical
difficulty in the
whole and avoid waste in maintaining the plant when completed.
In planning a new hospital or sanatorium the object should be to house the patients in a way that will provide as much comfort as possible. The size of the site and the block plan of the
grounds depend upon the number
the completed institution
of buildings to
be erected and the manner
to be administered.
Grounds For a sanatorium having a capacity open country, a
somewhat 20 ID 20 10 20
about one hundred patients situated in the
should consist of about two hundred acres of land, to be apportioned
in the following
40 acres for sanatorium buildings, amusements, park, forest and lake. farm buildings and the care of domestic animals. to 30 acres for a vegetable garden and potatoes. to 20 acres for an orchard and small fruits. to 30 acres for corn fodder. to
to 20 acres for
60 to 80 acres for pasture or grain. Usually a part of the drives, while roads
must be cleared and
laid out as a park,
or gravel paths with water mains beside
at suitable points are required near
and between the
with walks and
For such improvements on
the grounds from $2,000 to $10,000 should be appropriated.
situated beside or near a railroad, or an interurban trolley system, the
company may be
in sparsely settled parts of the
willing to construct
for the sanatorium.
country the transporta-
one story frame or brick structure 15 feet wide by 30 feet long, divided into one large room ^ 2 feet wide by 1 5 feet long, and having at one end a cov1 5 by 1 5 feet, and two small rooms 7 ered freight shed 10 feet wide by 20 feet long. When the right-of-way is near the sanatorium buildings the station can be used to house the post-office, telephone exchange, express office
store for the convenience of the patients
often wish to purchase material for
personal use. It
said to be an advantage to a transportation
company may be
right-of-way and in
to obtain the location of a
sparsely settled sections of the country the
to local people;
Si.ooo to 81,500 per month, a part of which, at least,
brings friends and visitors to nearby hotels, benefits the merchants,
The sanatorium has a
willing to gi\'e the land for the institution's site.
great educational value;
has a pay-roll of from
and creates a market
in the vicinity.
Buildings and Improvements for Block Plan
The following is a when laying out
of the buildings
to be considered
Administration Building. Service Building. Patients' Pavilions. Amusement Pavilion. Power House (Heating, Lighting
Industrial Shop. Ice-house or Cold Storage. Railroad Station, Post-office, and Telephone Exchange. Carpenter and Paint Shop. Store-house, Scale-house and Bakery. Green-house. Two hundred feet of Cold Frames or Forcing Beds. Vegetable Cellar. Garage. Barn for Horses.
Milk House. Colony Chicken Houses. Hog House. Sewage Disposal Plant. Sites for Hospitals to
The choosing of a
House Advanced Cases site
and the grouping
of the buildings of a hospital for far
cases usually presents an entirely different problem from that involved
sanatorium for incipient cases. in or
It is usually desirable to
when founding a
provide for the advanced patient
near the town from which he comes, and therefore the choice of a
site is largely
governed by the cost of the land and the attitude of the surrounding property owners.
hospital for this purpose should not be placed in a quarter where noise, the
from factories or the dust from uncared-for streets almost any
site is suitable
will affect the patients.
which can be easily reached, and is large enough to allow for the These questions are considered more in detail
construction of porches on the buildings. in
Section III, Administration Buildings and Patients' Quarters Combined. 24
EXAMPLES OF GROUPING AND The ings
and laying out
The Maryland State Sanatorium, is
following institutions are good examples of various methods of grouping build-
a well chosen site for a state institution, situated near the top of one of the mountains
Blue Ridge range, sixty-seven miles from Baltimore on the Western Maryland The sanatorium owns the station and has placed its power house on a siding
close to the railroad in order to run coal cars directly over the storage bins. site is
reached from the power house and railroad station by a well graded macadamized
road twenty feet wide and a quarter of a mile long, which ascends gradually through a beautiful woodland.
buildings have been placed on a comparatively fiat piece of
land lying on the south side of the mountain, with a beautiful view of the valley.
them the ground rises for about four hundred yards, protecting the site from the north winds. At the top of this ridge is a concrete reservoir, having a capacity of seventy thousand gallons and supplied with water by pumps in the power house. The buildings are grouped together as shown in the illustration because of the topographical features of the land. The Administration Building stands in front and is connected by a corridor with the Service Building directly in its rear. The sleeping shacks are arranged in two rows on both sides and to the rear of the main buildings and the slope of the ground allows a good view of the valley and mountain from their porches which overcomes the objection of The capacity of the plant placing the front of one shack directly in the rear of another. is two hundred patients at an estimated cost of $150,000.
The Georgia State Sanatorium, of
land comprising two hundred and fifty-seven acres, located on the main line of the
Southern Railway, two miles from Alto and seventy-four miles southeast of Atlanta, with
The elevation is about sixteen a station about a quarter of a mile from the institution. hundred feet above sea level in a part of the country comparatively free from dust and where the air is said to be pure and invigorating the year round. The land has a general slope to the southeast and is fairly well protected on the north and west by a rising hill and
The problem for seventy-five
to be solved
architects in arranging the block plan
white patients at the present time and prepare for a future growth of the
four hundred white and colored charity cases of was adopted because of certain peculiarities in the contour of the land, which lies in the form of a horseshoe made by a flat with two promontories jutting out from it on the same level. Between the promontories is a ravine forming the main axis of the block plan. The Administration Building is located on the flat, directly at the head of the ravine at the north of all the patients' quarters, which are arranged on the two promontories. This plan worked out so well that one contour line runs institution to three
through seventy-five per cent, of the buildings, adding greatly to ease of administration, as
a level path will connect them.
Practically everything on the grounds can be
seen from the administration building, as the other structures were arranged with that idea in view.
Nearest the entrance to the west
the Reception Hospital, where
be housed for observation on their arrival. 25
early cases will
< w h-l
a K H h -J
O :i ^ Ph -^ a — , a Tj ry ~
d2< < Q^z o ^ >
SECTION IV Hospitals for Advanced Cases, Infirmaries and Reception Hospitals
three types of buildings grouped together in this section for description, are
intended for patients
comfort, good nursing, and the housing supplied
by a same general purposes, that is, for the care of cases too sick to look after themselves, and at many institutions one building serves the purpose for which all are constructed and therefore it is hardly possible to separate them all
are used for the
for purposes of description.
Hospitals for Advanced Cases
These buildings patients
house and care of
open cottages. They are usually built on the lines of a general hospital, either the entire plant under one roof (as described in Section III) or on the pavilion plan. Also sometimes as a separate pavilion in connection with a general hospital or sanatorium in the open country. An advanced case hospital does not mean a home for incurables, for there can be no hard and fast line of demarcation drawn between curable and incurable cases. It has been found that many patients sent to institutions where they may be isolated until their to live in lean-tos or
death, improve under good hygienic surroundings and recover for It
the opinion of
authorities that the
advanced case does better on a porch
than in an enclosed room and can stand with benefit a comparatively large amount
It is therefore necessary that buildings for this purpose, besides
being heated, and supplied with the comforts and conveniences of a general hospital, must also
have large verandas connected with the wards and rooms by windows, cut down to
the floor, and doors through which beds can be rolled, in order to provide the for the
treatment necessary for incipient cases.
same facilities Such porches should be used in the disease, as there is hope for
by patients, even when far advanced in when they are not in a dying condition. Where very ill patients are to be cared for, it will give them comfort and save much labor if the rooms and porches are connected by some arrangement such as the Indiana pleasant weather all,
Convertible Sleeper, installed at the Indiana State Hospital (Illustration 46), which consists of a space three feet six inches wide across the entire front
between the porch and
room, enclosed on the outside by a glass and sash window that can be raised or lowered, and on the inside by glass doors that can be opened or shut. In this clear space between the doors and windows
doors and windows are both open, the front of the It is
is cut off from the room when the window is lowered. If room is entirely clear to the porch.
placed the bed, three feet wide, which
the doors are closed, and cut off from the porch
claimed for this arrangement that patients can be exposed to the Q[
on the porch,
Indiana State Hospital, Rockville, Ind. Brubaker & Steex. Architects. " Cox^'erteble Sleeper," Showing ARRAXCEiiEXT for Coxxectixg Rooms -mTH Opex Porches, ix Order to Expose the Patiexts to the Outer Air or Place Them ix Heated Rooms \\TTHorT ]Mo^'IXG the Beds. (See illustrations 7. 26 and 51 for further description of this institution.;
essential point to
planning buildings for advanced cases
that tuberculous patients in the last stages of the disease are A-ery annoying to each other,
and should therefore be housed in separate rooms instead of wards. They are easily affected by disturbances, and any excitement, such as grief, anger or worn,-, is usually followed by a fit of coughing and depression. Coughing is not only bad for the individual, but when patients are housed in wards, it may disturb ten or fifteen others, and is also a strong suggestion which often causes an epidemic of coughing among them. The mistake and cruelty of placing in one room a number of persons suffering from a serious chronic disease is only just beginning to be appreciated: and there is no doubt that many patients
satisfactory progress against disease
improve when removed to the quiet and privacy
in wards, rapidly
The single room more expensive to construct than the ward buildings, but they have advantages and it is easier to manage patients housed in them. The psychological tendency of a private room is to make patients more contented, and also to increase their self-respect. Advanced case hospitals are built not only in order to care for the patient, but also to prevent the spread of pulmonary tuberculosis, which is due in a great measure to the cases of consumption which remain and die in their homes infecting other members of their families. If all advanced cases could be cared for in hospitals, the disease would more rapidly disappear. Public opinion at present will not allow the passage of laws compeUing persons in the advanced stages of this disease to enter institutions for their segregation; of a separate
pavilions are slightly
therefore, hospitals should be
made comfortable and home-like
order to attract the
patients and hold them.
There are now in use for advanced cases at open air sanatoria pavilions constructed on the lean-to plan with the porches divided into single rooms and finished with plaster on the interior.
are closed in front with glass 92
and sash windows and make very
Hospitals for factory quarters
It is a simple
viding plenty of porch space and
Infirmaries and Reception Hospitals
of housing, has the
lean-to for sixteen patients finished for
can be built for from $5,000 to Sio,ooo, and when near an administration
bui.ding, administered as easily as a
Infirmaries In large tion with
where a hospital for the care of advanced cases has a working connecsanatorium in the country for the cure of incipient consumption, it
has been found that there
or less interchange of cases between the
Patients taken into the hospital for advanced cases, to be cared for until they die, often im-
prove under nursing, good food and hygienic surroundings, and are then sent to the country, while others fail
to the sanatorium for the cure seemingly only incipient cases, gradually
in strength or develop acute
remain there until they
symptoms and have
to be sent to the city hospital
This peculiarity of the disease has created a need for buildings on sanatorium grounds, where patients who have come to be cured, but develop symptoms of advanced disease, can be housed and cared for until they improve or are discharged. There is also a need in all large sanatoria for a building
where patients taking the open
they develop some other acute disease which requires nursing.
treatment can be placed
Buildings used for these
purposes are called infirmaries, and combine the structural details of both the general hospital
and the large open
air buildings of the
are often constructed as a
complete unit and administered separately from the other sanatorium buildings.
them have a dining room, kitchen and quarters for nurses and servants, who do not have any relationship except an official of
one, with other parts of the institution.
In some instances the infirmary building
houses the medical department and
be designated the medical building, as illustrated in this section,
dack Cottage and
by the Adiron-
These buildings should be heated and constructed of good material, fire-proof if possible, and with all the sanitary precautions taken to
a general hospital
comfortable and convenient, and the material
used in them from becoming infected.
pro^•ide a place for the
cases arriving at institutions for the treat-
pulmonary tuberculosis and where
No. 47.— Isolation Hospital, Paterson, N. J. Charles E. White. Architect. \'ie\v of THE CORXER OF OXE OF THE PoRCHES SHOWING Method of Heating for Advanced Cases by
be under observa-
tion in order that the physicians can classify
the stage of their disease and learn the idiosyncrasies of
(See illustration 52 for further STE.4M Pipes. description of this institution.)
treatment before placing them in open shacks and cottages. Reception hospitals are same purposes as infirmaries and should be constructed in the same
also used for the
manner and with
good material as
used for advanced case buildings.
EXAMPLES OF HOSPITALS FOR ADVANCED CASES Riverside Hospital,
The Concrete Pavilion
building is constructed of reinforced concrete, iii feet long
18 feet wide through
and was designed on the lines of a lean-to four stories high a sitting room between two open-air pavilions with dressing, toilet and bath rooms in a rear extension. It is used for advanced cases and arranged so that the front can be thrown entirely open converting the wards on each story into open-air porches. This building was designed to be used interchangeably for the care of cases of tuberculosis and the contagious disthe wards,
eases (measles, scarlet fever, etc.), according to the needs of the service.
The wings on the first floor are 36 feet long by 16 feet wide, with an apartment between them 29 feet long by 15 feet wide used as a dining room. The wards on the second and third floors are 41 feet long by 16 feet deep, with a sitting room 18 feet wide by 21 feet deep in the centre. The fourth story or roof garden is divided into two open wards and one open-air sitting room of the same dimensions as those below. The Riverside Hospital for advanced tuberculous patients is on North Brother Island at the upper end of the East River near Long Island Sound. The institution is The air is pure and so far as climatic conditions are concerned in an isolated position. open air building. The authorities feel that the advanced sheltered is an ideal site for a in a manner that will give them every chance of a housed patients sent there should be and these concrete pavilions are being built as an experiment with the hope that some the cases will respond to the treatment and that all the patients housed in these structures
do better than they did in the old block type of hospital. This building has a capacity of seventy-eight patients and the estimated cost
Jewish Hospital for Consumptives, Reisterstown, Md., Advanced Case Pavilion ^Illustrations 49 and 50). The building is 153 feet long including the side porches, and 57 feet deep through the wings; located on the southern slope of a hill, with a basement above ground on the south side. The material used for the foundations and walls of the basement is native stone, for the first story pressed brick, and the second The interior walls and ceilings are of hard plaster with story rough stucco on metal lath. round corners, covered with non-absorbent washable paint, and finished in plain wood surfaces; the floors are of hard wood dressed with oil. The basement contains the dining room 51 feet wide by 30 feet deep, kitchen 23 feet wide by 28 feet deep, serving room, pantry, fuel storage, laundry, sterilizing and drying rooms. There are sixteen single rooms in the building 10 feet wide by 12 feet deep and 10 feet high, and two wards of four beds, each patient being allotted twelve hundred cubic The sleeping porches in the centre of the building are 8^ feet long by 1 feet of air space. feet wide, protected at each end by the extension of the building, twelve feet to the south. The reception room, 21 feet wide by 23 feet long, and the superintendent's quarters, which 94
Infirmaries and Reception Hospitals
£ Tv/AD flooE Pzyif/
No. 48.— Riverside Hospital, New York City. Designed by Dr. Hermann M. Biggs. Westervelt & Austin, Architects. Concrete Pavilion for Advanced Cases. Front Elevation and Floor Plans. Capacity, 78 Patients. Estimated Cost, $40,000. 95
Section consist of office, sleeping room,
The main entrance to
are on the
the east wing.
and leads by a stairway
wall of the corridor
ends of the building are
and contain the
service stairways, lockers, diet kitchens, patients' toilets
first floor in
in the centre of the building,
deep from the
and baths, and baths, drug and supply rooms. nurses' rooms, toilets
centres of both the upper floors are used for housing the patients.
Their sitting rooms,
porches and sleeping apartments face the south and are protected from the north winds
by a heated corridor extending the entire length of the building. All the rooms are heated by direct steam radiators, lighted by electricity, provided with electric bed ^l-armers, have electric connections with the nurses' apartments and are screened against insects. The doors open on to a porch in front and into a corridor at the rear six feet wide, and over them are movable transoms giving cross-ventilation above the beds. The doorways are wide and have no sills, so that the beds can be rolled through either end and moved from one floor to another on the elevator. The building was erected for advanced cases with the idea of obtaining unobstructed cross-ventilation from every direction without mechanical means, and of giving most of the patients an individual room with porch space equal to its floor area. The building has a capacity of twenty-four beds and cost S30.000.
— Jewish OK \'ir:\v
Hospital for Consumptives, Reisterstown, Md. i'A\ iliux i-ur Advanced Cases. Front and Rear Elevations. Capacity, 24 Patients. Cost, $30,000. 96
Hospitals for Advanced Cases, Infirmaries and Reception Hospitals
Hospital for Consumptives, Reisterstown, Floor Plans. Capacity, 24 Patients.
Paviliox for Advanced Cases.
Indiana State Hospital, Rockville, Ind., Ward Building (Illustration 51). one of two similar buildings connected \\ith the administration building illustrated in Section II. It is 295 feet long, 59 feet deep through the centre and 25 feet deep through the wings, two stories without a basement, and of frame construction on a concrete foundation. On each side of the central section the w'ngs are divided into a row of single rooms This
by 10 feet deep, with a sleeping porch 10 feet wide and 100 feet long in the and a corridor five feet wide in the rear. In the centre is a sun parlor 30 feet wide by 33 feet deep, a nurses' room 14 feet wide by 20 feet deep, a diet kitchen 13 feet wide by 13 At the outer ends are the patients' toilets, baths and feet deep and a serving room. 10 feet wide
corridor in the rear of the
passageway with a
rooms on both
connected by an enclosed
hall in the administration building, in order that the patients
Under these passageways are tunnels connecting the pavilions, administration building and power house, and carrying the service pipes, lighting wires and heating mains. The rooms on the first floor are protected on the front by double glass doors opening out on to the sleeping porches, through which the beds can be run when desired. Those
bad weather while going
51. Indiana State Hospital, Rockville, Ind. Waed Building. Brubaker & Stern, Architects. View of Front Elevation and Floor Plan; Both Floors Alike. Capacity, 40 Patients. Estimated Cost, $30,000. (See illustrations 7, 26 and 46 for further description of this institution.)
on the second
equipped with an arrangement called the "Indiana Convertible
Sleeper," described on pages 91
building has a capacity for forty patients,
housed in single rooms, at an
cost of $30,000.
Isolation Hospital, Paterson, N. J., Tuberculosis Pavilion (Illustration 52). a two story building constructed of reinforced concrete, with concrete floors, and is
throughout with the exception of the window frames and the framework
Paterson Isolation Hospital, from which
a pavilion to house advanced tuberculous patients in connection with the it is
building, not including the porch,
56 feet deep
27 feet wide.
plans of both stories are alike, divided into a ward 24 feet wide by 25 feet deep, two private
wide and 12 feet long, a linen room 6 feet wide by 10 feet long, a diet kitchen
sitting room 8 feet wide by 10 feet long, containing and stationary wash-stand, and a lavatory 10 feet by 10 feet, containing bath, wash-basins and toilet for the patients. The porches extend on both stories along the entire front, 12 feet wide by 38 feet long, and on the south side of the building 11 feet wide by 42 feet long, floored with con7 feet
wide by 10 feet long, and a nurses'
Hospitals for Crete, enclosed
with swinging glass and sash windows and heated by steam pipes which
extend along their outer edges.
The include tion,
Cases, Infirmaries and Reception Hospitals
(See illustration No. 41.)
and cost Si 2,096, but this does not proportion of the expense of the power house or the enclosed corridor construcpavilion has a capacity of twenty-four beds
with the administration building.
walls of frame with brick veneer externally.
FIRST AND SECOND
shingled and the interior walls
Hospital, Paterson, N. J. Charles E. White, Architect. Pavilion for View of Front and Side Elevation. Floor Plan; Both Floors are Capacity, 24 Patients. Cost, $12,096. (See illustration 47 for further description of this
Advaxced Cases. Alike.
Fort Bayard, N. M., Officers'
a single story building with a stone foundation and
The building is 147 feet long by 34 feet wide, heated by a hot water system and lighted by electricity. It is divided down the centre by a corridor six feet six inches wide, and has eighteen rooms for patients, twelve on the south side and six on the north side, all of the same dimensions, 11 feet wide by 13 feet deep. These rooms open upon covered sleeping porches about ten feet wide, with doorways made wide enough so that There is also an office 11 feet wide by 13 feet long, the beds can be rolled through them. an attendants' room, baths and toilets. The capacity is eighteen patients and the building plastered.
United States Army General Hospital, Fort Bayard, N. M., Enlisted Men's 2 (Illustrations 54 and 55). Ward Two is a single story structure, constructed of concrete with "pebble-dash" finish and built around a central court or "patio" 59 feet wide by 79 feet long. The building including the court covers ground space 100 feet wide by
130 feet long.
Platforms or porches ten feet wide extend around the interior of the building
on the sides of the court where the beds and sun by canvas curtains on rollers.
of the patients are placed
At the corners
and protected from rooms 23
of the building are
No. 53.— United States Army General Hospital, Fort Bayard, N. M. Officers' Quarters. View OF Front and Side Elen'atkjn and Floor Plan. Capacity, 18 Patients. Cost, $18,534.
Hospitals for Advanced Cases, Infirmaries and Reception Hospitals
No. 54.— United States Army General Hospital, Fort Bayard, N. M. Designed by Major George E. Bushnell. Enlisted Men's Ward No. 2. View of Front and Side Elevation AND Floor Plan. Capacity, 32 Patients. Estimated Cost, $25,000.
Hospital, Fort Bayard, N.
\"iew or Inxer
Showing Sleeping Porches.
wide by 23 feet deep, used for offices, lavatories, storage and attendants. These rooms are connected by long narrow apartments 14 feet wide by 68 feet long, on two sides of the building,
wide by 50
on the others, intended as dressing rooms rather
than sleeping rooms, but used for the latter purpose in stormy weather. Numerous French windows open from the dressing rooms on to the porches facing the court and also
upon porches constructed on the outside of the building. This arrangement permits the beds and reclining chairs to be moved freely on to a platform having any exposure desired and gives the patients an opportunity to seek or avoid the sun at pleasure. It is reported to be very satisfactory and that two other buildings of the same design will be constructed. This type of building is especially good for dry, tropical countries, but can be used for It patients' quarters in any climate if the porches are protected by permanent roofs. has a capacity for forty patients and the estimated cost is $15,000. Lakeville
Case P.wiliox up
Mass., The Advanced a group It
forty-eight feet long, of frame construction, placed on a stone foundation, piers.
It consists of a central section 36 feet
two twenty-bed wards 64
two hundred and
wide by 62 feet deep (including the rear
and two twelve-bed open
air pavilions built in the form of a right angle, extending forty feet from the outer ends of
the wards. floor is a
central section of the building has
sun parlor, three small wards, a diet kitchen, treatment room,
Hospitals for The second cellar is of
Cases, Infirmaries and Reception Hospitals
36 feet wide by 50 feet deep and
about the same
used for lockers,
divided into nine rooms.
rooms and storage purposes.
wards are an objection to using the plan for this building, but they could be and it is easy to administer. It would also be improved by dividing the locker rooms, bath rooms, and toilets on the main floor into two sections, providing a nurses' office, one or two more pri\'ate rooms, a larger sun room, and larger wards, gi\dng more large
space to each patient.
building has a capacity for seventy patients, and cost $17,600.
Boston Consumptives Hospital, Boston, Mass., Cottage tor Advanced Cases
foundation and concrete first
a frame building with a shingle roof, placed
interior walls are plastered
an assembly room 22
on a concrete floors are of
144 feet long and 25 feet through the wards, including
the porches, with a rear extension 45 feet deep and 28 feet is
front in the centre
wide by 24 feet deep and in the rear extension an emergency
No. 56.— Lakeville Tuberculosis Hospital, Middleboro, Mass. Johx A. Fox. Architect. Pavilion FOR Advanced Cases. \'ie\v of Front and Side Elevation and Floor Plan. Capacity, 70 Beds.
Cost, $17,600. 103
D, Toilet-room. E, Nurses' Office. F,
Consumptives Hospital, Mattapan, Mass. Maginnis, Walsh & Sullh'an, Cottage Waed for Ad\'anced Cases. View of Front Elevation and Floor Plan. Capacity, 24 Patients. Cost, $14,000.
feet wide by 11 feet deep, two dressing rooms by 21 feet deep, each containing twelve lockers 3 feet wide and 2^ feet deep, and two toilet rooms 27 feet wide by 13 feet deep, furnished with six lavatories, four toilets, two baths and two showers. The wards face the south, are 14 feet wide by 16 feet long, and each contains a single row of twelve beds, with a veranda in their front 10 feet wide by 60 feet long, separated from the wards by a glass partition made up of triple hung windows
two beds and a nurses' room, both 10
14 feet wide
extending from the roof to the
Infirmaries and Reception Hospitals
Along the north
side of the
a row of windows
which give cross-ventilation. It has front, as
hung windows on the advanced heated by steam, lighted by electricity,
been suggested that doors be substituted
they are rather heavy and hard to move. is
very satisfactory for the purpose.
for the triple
has a capacity for twenty-six patients, and cost, including equipment, $15,000.
EXAMPLES OF INFIRMARIES AND RECEPTION HOSPITALS Maine State Sanatorium, Hebron, Me., The Infirmary This
a frame structure, on a stone foundation.
Under the left wing the ground
falls off to
No. 58.—Maine State Sanatorium, Hebron, Me. T. C. Stevens and J. H. Stevens, Architects. Infirmary. View of Front Elevation and Floor Plan. Capacity, 30 Patients. Estimated (See illustrations 11 and 23 for further description of this institution.) Cost, $30,000. _
such an extent that an open ward was constructed in the basement, providing an arrange-
on the floor above. The building consists of a centre section, two two wings and a rear extension. The front of the building is in the form of an acute angle and has a porch running its entire length, eleven feet wide. The wings are 32 feet wide by 61 feet long, divided into nine single rooms each 7 feet \\dde by 11 feet deep, ^^'ith a closet 3 feet wide by 2 feet deep, and a passageway or corridor four feet wide in their rear. It should be noted that the rooms are ventilated by transoms opening above the roof of the porch through which sunlight is obtained and that the arrangement of Behind the corridor in each wing closets in connection with the sleeping rooms is unusual. containing lavatories, toilet and baths. an extension long feet deep, is by 7 27 feet the rear extension, section building, including is 30 feet wide The central of the
similar to that
Designed by Dr. Hermann M. Biggs. J. D. Burt, Architect. \\'omen's Infirmary. \'iews of Front and Rear Elevations. Capacity, 24 Patients. Estimated Cost S5.000. fSee illustrations 14, 28, 85, 94 and loi for further descriptions
No. 59.— Municipal Sanatorium, Otisville, N. Y.
of this institution.;
and Reception Hospitals
—Municipal Sanatorium, Otisville, N. Y.
Designed by Dr. Hermann M. Biggs. J. D. Burt, Floor Plans. Capacity, 24 Patients. Estimated Cost, $5,000.
by 82 angles
feet deep, divided
through the centre by a hall four feet wide, which
corridor leading to the wings.
private patients, 11 feet wide
other one private room, a dining
wide by 13 feet deep.
13 feet deep,
cut at right
one side of the hall are two rooms, for
an operating and preparation room; on the by iS feet deep, and a kitchen 16 feet
16 feet wide
of the extension are only approximate, as the rear
and sides of the building are broken and project in order to give space for the dining room and kitchen. This building is connected by a tunnel with the administration building and is heated from the central plant. The capacity is for thirty patients at an estimated cost of $20,000.
Municipal Sanatorium, Otisville, N. Y., Women's Infirmary (Illustrations This building is a two story frame structure which rests on a stone foundation and stone piers, with a basement under the central section 25 feet wide by 29 feet deep. The exterior of the building is covered with shingles, stained green, with cream colored trimmings and the roof is also of shingles stained a Tuscan red. It is 88 feet long by 16 feet wide through the wards, and 28 feet through the centre, and consists of a centre section and two wings. The first floor is divided into two open wards for six patients each, 16 feet wide by 27 feet long, a sitting room 24 feet wide by 14 feet deep, a locker and dressing 59 and 6oj.
UBS i' ^l^kijkW*
Infirmary Sanatorium, Towson, Md. Archer & Allex, Architects. the Front .and Rear Elevations. Floor Plans. Capacity, 30 Patients. Estimated Cost, $30,000. (See illustrations 22 and 83 for further description of thus institution.) 6i.
II feet wide
13 feet deep, baths, toilets
and attendant's room
wide by 14
two small open wards iS feet wide by 16 feet deep, two by 14 feet deep, a small hall four feet wide, two dressing rooms with lockers 10 feet wide by 12 feet deep, diet kitchen, 9 feet wide by 9 feet deep, and an enclosed infirmary ward 24 feet wide by 14 feet deep, situated over the sitting room in the sitting
12 feet wide
centre of the building with a capacity of four patients.
building has good
modern plumbing throughout and 108
heated through direct
Cases, Infirmaries and Reception Hospitals
by a steam heating plant
basement which also contains a water tank for is no stairway connecting the two iioors, the upper story being reached by a platform running from a steep side hill in the rear of The front windows are all arranged so that both sashes can slide into pockets, the building. radiators
supplying hot water for
By this means the infirmary can be changed when The capacity is twenty-four beds, and the cost of construction
leaving the openings entirely free. desirable into
an open ward.
Eudowood Sanatorium, Towson, Md., Infirmary Building This
a frame structure, covered externally with shingles, resting on a stone foundation
It is 192 feet long by 25 feet wide, through the wards, and consists of a two wings and three rear extensions. The centre of the building is two stories with a cellar and is designed after the Colonial style of southern architecture, 36 feet wide by 46 feet deep including the porch, but not the rear extension, which is 17 feet
wide by 35 feet deep. On the front is a sitting room 35 feet wide by 16 feet deep and behind it a hall four feet wide uniting the two wings, an examining room, a linen closet and a storage
15 feet wide
and and a kitchen 15 The cellar contains rooms for the heating plant and feet wide by 14 feet deep behind it. storage and the second story four bedrooms, closets, baths, toilets and a sleeping porch II feet wide by 34 feet long for the use of the nurses. The wings including the private rooms and porches at the ends are 98 feet long by 25 feet wide, and are divided into two wards for six patients each, 31 feet long by 13 feet deep, with a porch in their front 10 feet wide by 78 feet long, three private rooms at the outer ends each 8 feet wide by 10 feet deep, a private porch 24 feet wide by 8 feet deep, and in the rear an extension 16 feet wide by 21 feet deep, containing lockers, toilets and baths, and a dressing room. This building is considered a model for a good infirmary at a large sanatorium, well provided with other buildings. Twenty-four patients are housed in small wards; six in private rooms, and all having private alcoves in the dressing is
21 feet deep, partly in the central section
partly in the rear extension, with a pantry 15 feet wide
vided for the nurses and attendants, a dining room, kitchen, and other necessary apartments.
plans are worth careful study, and the private rooms at the ends of the
wings, with a private porch which cannot be overlooked from the
Edward Sanatorium, (Illustration 62).
and roofed with
unfinished attic lighted
Infirmary and Medical Building
a two story frame structure, on a stone foundation, painted white It
70 feet long by 34 feet wide and has a basement and an
by dormer windows.
contains a disinfecting
wide by 14 feet long, a disinfecting plant for sputum cups, coal storage 24 feet long by 14 feet wide, a carpenter shop 9 feet wide by 16 feet long, a mortuary 6 feet wide by 7 feet long, a dressing room 10 feet wide by 12 feet long, with two shower baths, and an engine II feet
16 feet wide
and hot water tank. by a hall and contains a reception room wide by 12 feet long, a dressing room 6 feet wide by 11 feet long, a diet kitchen 7 feet wide
17 feet long for the. heating plant,
first floor is
and superintendent's office, both 11 feet wide by 10 feet long, a drug room 10 feet by II feet long, and two dressing rooms and lockers.
for the infirmary patients, with toilets, baths
No. 62. Edward Sanatorium, Naperville, 111. Designed by Dr. Theodore B. Sachs. W. A. Otis AND Edward H. Clark, Architects. Infirmary and Medical Building. View of Front and Side Elevations antd Floor Plans. Capacity, 12 Patients. Cost, $21,435. (See illustrations 82 and 88 for further description of this institution.)
The second story is also divided by a hall running through the centre of the building and arranged with rooms for the superintendent, physician and nurses, and two dressing rooms with toilets, baths and lockers. The infirmary is housed on two large porches 31 feet wide by 18 feet deep, one on the first and the other on the second floor, facing the south and protected on the west by windows, on the north by the wall of the building and on the south and east by canvas curtains. Each porch accommodates six patients, the lower for men and the upper for women. The building was carefully designed and
Cases, Infirmaries and Reception Hospitals
simply finished with round corners, smooth surfaces, walls.
heated by steam, well ventilated and cost $21,435.
Adirondack Cottage Sanitarium, Saranac Lake, N. Y., Infirmary and Medical Building (Illustration 63). This building consists of a basement and two stories with walls of the foundation and
story constructed of native stone two feet thick.
frame with a shingled
exterior, extra insulation against cold having been obtained by using two layers of paper and siding between the shingles and interior
Its peculiar right-angle
due to the position
of the site, as there
room enough on the land to place a straight structure. The width of the front is twentytwo feet at the angle, and the length of each side on the front is fifty-three feet and on the rear forty-six feet. The basement contains the heating plant, and a store room used in connection
On to a
with the laboratory. first floor
are eight patients'
porch 10 feet wide by 60 feet long, with a corridor
wide by 13 feet deep, opening on wide in the rear; a nurses'
No. 63. Adirondack Cottage Sanitarium, Saranac Lake, N. Y. Scopes & Feustmann, Architects. Infirmary and AIedical Building. View of Front and Side Elevations and Floor Plans. Capacity, 10 Patients. Cost, $26,000. (See frontispiece and illustrations 13, 98, 104 and 109 for further description of this institution.)
9 feet wide
13 feet deep, a sitting
13 feet wide
nurses' ofi&ce in the angle 10 feet wide at the widest point
windows are mirrors
of this office next to the
in the centre of the lockers, baths
13 feet deep
In the corners
so arranged that the nurse sitting at a desk
able to overlook both porches.
toilets, a hall,
In the rear
of the corridor are
stairway and the main entrance.
The second floor is divided into a laboratory 27 feet long by 16 feet wide, a treatment room 10 feet wide by 13 feet deep, an examination room 13 feet wide by 17 feet deep, a throat room S feet wide by 9 feet deep, a patients' waiting room 11 feet wide by iS feet deep, a drug room 10 feet wide by 13 feet deep, an .v-ray room 9 feet wide by 13 feet deep, a doctor's office 14 feet wide by 15 feet deep, a statistician's office 12 feet wide by 15 feet deep and two porches 11 feet wide by 20 feet deep, on which the medical staff work on pleasant days.
In order to economize on the cost of construction, this structure was made to combine the purposes of an infirmary, reception hospital and medical building. first
arriving at the sanitarium are cared for on the
for the is
of the medical
while the second floor
interesting feature of the building
the arrangement of the transoms in the patients' rooms over the roof of the porch.
This overcomes the disad^'antage a continuous porch,
out the sunlight when rooms are flanked by
can only be planned for when patients are housed on one
building has a capacity for ten patients and cost $26,000.
Maryland (Illustration 64 j.
frame construction, placed on a stone foundation, and
No. 64. Maryland State Sanatoriiun, Sabillasville, Md. Wyatt & Nolting, Architects. Infirmary Building. View of Front Elevation, and Floor Plan. Capacity, 20 Patients. Estimated Cost, Si8,ooo. (See illustrations 3 and 75 for further description of this institution.)
Infirmaries and Reception Hospitals
No. 65. Georgia State Sanatorium, Alto, Ga. Scopes & Feustmann, and Walter W. Judell, Associated Architects. Infirmary Building. View of Front Elevation, and Floor Plan. Capacity, 24 Patients. Cost, $18,000. (See illustrations 4 and 78 for further description of this institution.)
stone piers, and covered on the exterior with shingles.
designed on the same lines
as the lean-tos for housing the incipient patients at this institution. It consists of a central section,
195 feet long
two wings and three small rear extensions, and
length of the building and in
containing a nurses' room 9 feet wide
The central section is 28 feet wide by 32 feet deep, containing a wide by 18 feet deep and two small linen closets. The corridor runs
rear are three extensions, the one in the centre 9 feet long, a diet kitchen 9 feet wide
wide by 9 feet long.
deep by 31 feet wide and contain the
Those in the rear of the wings are 36 and baths. The capacity is twenty
patients at an estimated cost of $15,000.
Georgia State Sanatorium, Alto, Ga., The Infirmary Building 65).
a one story building with a basement, of frame construction, placed on a
foundation of local stone 18 inches thick.
It is covered
with shingles on the outside,
having one thickness of siding and building paper over the studs and plastered on the inside over wood lath. It is 150 feet long by 25 feet through the ends, and 37 feet
wide through the centre which 8
divided by a large lounging hall 12 feet wide by 35 feet 113
cut at a right-angle
wide and 92 feet long, uniting
the two wards, which are both 24 feet wide by 29 feet deep and have a capacity of eight There are sleeping porches 10 feet wide by 34 feet long, for six patients patients each. each, at the ends of the building, a porch 12 feet wide
the south, and two porches both 10 feet wide
on two patients each, on the
feet long for eight patients
feet long, for
No. 66.— Danvers State Hospital, Hawthorne, Mass. Designed by Dr. F. Page. Pavilion; View OF Front and Side Ele\ation and Floor Plan. Capacity, 16 Patients. Estimated Cost, S6,ooo. 114
Hospitals for Advanced Cases, Infirmaries and Reception Hospitals
67. Ohio State Sanatorium, Mount Vernon, Ohio. I-". L. Packard, Architect. Reception Hospital. View of Froxt Elevation and Floor Plan. Capacity, 24 P.atients. Estimated Cost, $30,000. (See illustration 77 for further description of this institution.)
In addition to the wards there are
conveniently placed locker rooms,
baths, linen closets
wide by 13
was planned so that it could be used as a temporary administration building, The architect easily and economically turned into a well laid-out infirmary. designed the infirmary first and then worked out the arrangement for administrative purstructure
The ward on the east end was converted into a beyond enclosed for a kitchen and pantry, and the north porch enclosed for a staff dining room. The ward on the west end was cut down to a capacity for six patients and the remaining space converted into sleeping rooms for two nurses. The balance of the building as constructed will not be changed. When converted into an infirmary it will have a capacity of twenty-four patients. The cost of construction was $iS,ooo. poses for which dining
room and the
Danvers State Hospital, Hawthorne, Mass., Tuberculosis Pavilion tration 66).
This pkvilion was erected to house insane tuberculous patients, but
arranged for use as a reception cottage feet
wide by 32
small observation wards are desired.
a large, well screened porch 11 feet wide
wide by 20
feet deep, opening into a dining
room is an The arrangement of
rear of the dining
attendants' room, pantry, toilet and bath. it is
and the glass in the at an estimated cost
structurally a part of the building
with two small wards 20 feet wide by 20 feet deep, for eight
patients each, on either side.
It is 60
with a rear extension 35 feet wide by 18 feet deep and
frame construction, covered with shingles and heated with steam. feet
extension containing the
the porch is
an unusual feature.
Ohio State Sanatorium, Mt. Vernon, Ohio, Reception Hospital
on a concrete foundation, with This building is two 67). through the wings. Both trimmings, and tile roof, feet long and feet white stone a 147 37 central section, two wings and a same general floor plan, consisting of a stories have the stories high, constructed of brick,
In the centre
loggia on the front 31 feet wide
31 feet wide
13 feet deep.
rooms 8 feet wide by 10 feet deep, with a corridor
15 feet deep, with a porch or
The wings are divided into five feet
wide at their rear and a porch
by 55 feet long on the front. The rear extension is 32 feet wide by 59 feet deep, divided by a corridor in the centre six feet wide, with rooms on either side used for toilets, baths, storage and attendants. The building has a number of good features. It is well constructed and the patients The arrangement of the passageways, corridors and the are housed in separate rooms. It has a capacity of twenty-four patients' closets are convenient and should be noted. or loggia 12 feet wide
patients at an estimated cost of $20,000.
SECTION V Patients' Quarters
— Lean-to Type
SECTION V Patients' Quarters
is a study of the growth and changes made in the lean-to t}^e of building was first adopted for housing incipient tuberculous patients. The many modificahave tended to increase the capacity rather than to change the form. In some
instances the expansion has been upwards, while in others the porches have been lengthened.
building of this design can be cheaply constructed and has proven to be comfortable
and serviceable both when put up in a rough way structed and finished on the interior for advanced
for incipient cases,
Origin of the Lean-to
idea of housing tuberculous patients in lean-tos
King, of Loomis Sanatorium.
lean-to camp, which
suggested by Dr.
took as his model the old-time Adirondack
usually built of a framework of poles covered with bark, and de-
scribes his first building as a shed with
constructed to be opened or closed as occasion demands.
with the ends
In the back wall were three
openings in which were placed stationary slat blinds, intended to increase the circulation of air, floor
but which produced too direct a draught for use in winter.
space 12 feet wide
feet long, giving
building had a
for eight 30-inch beds,
and was con-
structed of plain lumber neither painted nor stained on the interior and covered externally
In order to make
it serviceable for the winter it was necessary to proroom near at hand. This was obtained by an addition placed directly behind the lean-to and fitted with toilets and wash basins and heated by a stove surrounded by a water coil which provided hot water for toilet purposes. Later the design for this simple structure was modified, and a larger and more This consists of two lean-tos placed end to end, somewhat elaborate building constructed. wider than the original, and connected by a sitting room for use in bad weather, with a double locker and dressing room directly back of it in an extension. The advantage obtained by this impro\'ement over the first building was ample space for reclining chairs at the foot of the beds, protected from the weather, a warm sitting room and a larger dressing
with cedar shingles.
vide a heated dressing
apartment. In designing and constructing lean-tos for housing incipient patients the following points should be considered.
Material Shall the lean-to be constructed with material that will make a fairly permanent and comfortable structure? It would seem as if the funds available must settle this question, for good results are obtained from the open-air treatment in cheap buildings, although some of them are only shacks without plumbing or heating arrangements, where the patients use the old style wash-bowl and pitcher, or go to a small central building 119
tuberculosis, patients usually
During the early stages
stand the exposure to cold weather on the porches very
they have a heated apartment near at hand to which they can go for 'dressing and
order to get warm.
they are not substantial, permanent buildings, and cost more to maintain in good order
On the other hand, it is contended that they can be torn on the same lines a number of times for less monej' than it costs to erect a permanent structure which may become out-of-date. There is no doubt that a happy than the more costly structures.
between the extremes
of a shed
of comforts, costing
$50.00 to $75.00 per patient, and some of the elaborate buildings classed as lean-tos which
from $400.00 to^Soo.oo per patient. Lean-tos are usually built of frame construction, consisting of a frame made from timbers to which sheathing is nailed and in turn covered externally with cost
shingles or one of the patent board sidings.
well seasoned hard pine timbers are
used for the columns and beams of the porch frame, and planks such as are specified in mill construction placed in the floor and roof, the result
a fairly substantial and perma-
usually covered with shingles, but tin, slate,
or one of the
patent roofing materials will give good service.
Floors In the sitting room the material for the floors should be hard wood or well laid and
The latter gives good satisfaction and rugs can be used over it. In the extension and dressing rooms, a flooring should be used which will not be affected by water, such as one of the composition materials in which cement is the predominating element, ordinary cement flooring, tile, terrazzo, or a carefully
seasoned ordinary floor boards, covered with linoleum.
No. 69. Catawba Sanatorium, Catawba, Va. Designed by Dr. Enxiox G. Williams. View of AX Oi'Ex Porch Illistratixg a Method of Construction without Interior Finish, and A Manner of Protecting Porches by Canvas Curtains under the Edge of the Roof Projection. (See illustrations 1 7, 30 and 80 for further description of this institution.)
North Reading State Sanatorium, North Reading, Mass. John A. Fox, Architect. View OF AN Open Porch, Illustrating a Method of Protecting Porches by Canvas Curtains in
(See illustration 87 for further description of this institution.)
covered with battle-ship linoleum or modern cork matting, glued down and
turned up at the base
last are durable, noiseless
narrow boards or metal lath.
can be finished either by sealing the walls and
varnished, or the plaster covered with
when used should be
In the rear extension or dressing rooms hard, smooth plaster over metal lath
one or more thicknesses of building paper or by plaster over wood
and this should be painted and covered with coach varnish, and the walls for feet up from the floor protected by tile, or imitation tile made of metal covered
by enamel. The
finish for the interior of the
The timbers may be
sealed with boards
porches depends upon individual taste and need for
exposed in the rough, planed, painted, stained, or
Excavation Basements and cellars do not afford the most sanitary means of obtaining storage and extra room in hospital buildings, and excavations can be eliminated by raising lean-tos If there is reason to fear off the ground one to three feet on stone, brick or concrete piers. dampness a layer of concrete about three inches thick should be spread upon the ground under the building.
placing of the building in
relation to the points of the
Usually the exposure of the porches should be south-east rather than due south in tern-
perate climates, for since the lean-to has become popular
has been found that the
the porches with direct southern exposure often gets exceedingly hot, and sometimes un-
summer months, causIn hot countries and where the summer temperature hours at a time, lean-tos should have two porches for each group of pa-
bearable during the middle of the day and the early afternoon, in the ing the patients great discomfort.
remains high for
one having a southern and the other a northern exposure.
plan or designing a new lean-to, care should be taken to have the enough to give space for a storage room, a linen closet, a warming closet in which blankets can be quickly dried and warmed, and large indi\ddual lockers 3 In many of the earlier constructed lean-tos the lockers are feet wide by 3 to 5 feet deep. often not more than 12 inches wide by 12 inches deep, too small to allow any privacy to the indi\ddual. It should now be definitely understood that no building for the housing of incipient patients is complete unless it provides adequate facilities to each person for privacy. The latest lean-to constructed at the Loomis Sanatorium is a good illustration of one method
In selecting a
rear extensions large
need with a large locker or a small private dressing room.
The arrangement of patients
of the porches
divide the patients into small units. 8 feet
also being modified in order to reduce the
Large porches should have partitions erected in order to
Two patients in
a small cubicle about 10 feet wide
deep seems to be the most satisfactory arrangement.
rear walls in
tilate a lean-to built in this
cases are too low.
a mistake, as
hard to ven-
manner, and causes the patients discomfort when moving
least eight feet in the clear should
The width of
of the floor space
and roof projection should be ample,
lean-to provides the living quarters of
as the porch
No. 71.—Virginia State Farm, Richmond, Va. View of Open Porch Illustrating Manner of Pkotectixg Porches by Canvas Curtains Placed between Pillars, a Few Feet Back from the Line of the Roof Projection.
—Lean-to Type of Building
Loomis Sanatorium, Liberty, N. Y. View of Chapman Cottage. Sleeping Porch; Illustrating AIethod of Construction and Interior Finish, Using Narrow Floor Boards for Sealing. (See illustrations i, 73, 91 and 108 for further descriptions of this institution.)
freely at the foot of their beds
clear space for a reclining chair are necessary.
one of the best protections against storms and high
winds, and should be three times the length of the bed, eighteen feet or more from the rear wall to the front line.
front of the porch
nese matting, glass and sash window^s which can be raised and lowered, or glass doors which
The rear and end openings are generally protected by sliding windows known as the "barn-door" shutter, ordinary glass and sash windows hung either at the side or from the top, or a frame covered with canvas hung on hinges or on a pivot. can be opened and closed.
one of the most important questions to be considered when planning
air in a room with an open front as it room enclosed by four walls. When cross-ventilation is not obtained the air becomes very bad at the back of the porches. This can be prevented if special care is taken to secure cross currents of air, by windows cut in the side and rear walls, or by openings above the porch roof which remove the foul air close to the ceiling.
lean-tos, for is
about as hard to obtain a current of
Fixtures and Plumbing
substantial sanitary fixtures should be used in the dressing rooms, allowing one
and one wash-basin to every Plumbing should not be installed toilet
and one shower or bath tub
to every eight patients.
in cheap lean-tos in northern climates unless 123
Herbert Maxox King. Cost, $1,830.
Original Improved Lean-to. Designed by Elevation and Floor Plan. Capacity, 108 for further description of this i, 72, 91 and
protected, or frozen pipes will give visable to
trouble during the winter months.
for heating porches to be used
incipient patients, as
has been found that expensive heating plants provided for this purpose are rarely used.
A comparison of the various floor plans of lean-tos described in
in illustration 68.
EXAMPLES OF LEAN-TOS 73).
Loomis Sanatorium, Liberty, N. Y., The Improved King Le.\n-to (Illustration is 100 feet long by 25 feet deep, of frame construction, placed on stone
and covered externally with cedar shingles
ture used as the model for the lean-to type of building.
the original struc-
in the centre is
and the dressing room directly back of it is 20 feet wide by 14 feet deep, both being heated by a large stove which also supplies hot water for the baths and hand basins. The interior finish of the centre apartment is hard pine, filled and var20 feet wide
25 feet deep,
—Lean-to Type of Building
forty feet, the extent of the roof projection twenty feet,
a great help in keeping out a driving storm.
They are simply and cheaply x 4 timbers supporting the walls and roof are left uncovered, and the smooth surfaces are painted with the exception of the floor, which is laid in the ordinary way except where ex-posed to the rain. In these places it is made of three inch material is
with one-half inch spacing between each plank, the edges being slightly rounded, to prevent curling. The building faces the south and during storms the porches are enclosed by
canvas curtains on of sixteen
which can be raised or lowered.
building has a capacity
beds and cost $1,830.
Michigan State Sanatorium, Howell, Mich., Lean-to
(Illustration 74). This placed on stone piers, of frame construction, with a shingled roof, 102 feet long by 25 feet wide through the wards. The rear extension is 25 feet wide by 19 feet deep and the entire floor plan is simflar to the improved King lean-to, but with a different arrange-
of the lockers, toilets
substantially constructed, having glass terrace in front
and sash windows
and more commodious dressing rooms.
also better finished
to enclose the wards, a large
the cost of construction w^as 84,500.
No. 74.—Michigan State Sanatorium, Howell, Mich. Malcomson, Higixbqtham and Clement, Architects. Leax-to. View of Front Elevation .\nt) Floor Plan. C.vPACiTY, 16 Patients.
Floob Plan of Shacks.
Maryland State Sanatorium, Sabillasville, Md. Wyatt & Nolting, Aechitects. Lean-to. 75. View of Front Elevation, Floor Plan and Cross-section. Capacity, 20 Patients.
Estimated Cost, $7,000.
(See illustrations 3
for further description of this institution.)
Maryland State Sanatorium, Sabillasville, Md., Lean-to for Incipient Patients (Illustration 75). This building is of frame construction, placed on brick piers, both the roof and exterior walls being covered with shingles and stained. The trimmings around the windows are painted white and the interior sealed with narrow boards and varnished. The structure is 123 feet long by 26 feet deep through the wings, which are divided into a ward for ten patients, 16 feet wide
wide on the
by 50 feet long, with porches ten feet by 30 feet deep and is divided into wide by 22 feet long, arranged to give each
32 feet wide
three apartments, two dressing rooms, 14 feet patient a private dressing alcove containing a set of drawers, and space for hanging clothes,
wide by 10 feet deep, containing ample bathing 126
facilities as well
—Lean-to Type of Building
The sitting room between the wards is 22 feet wide by 18 feet same manner as the other parts of the interior. There are ten of these buildings grouped about an administration building, which is described in Section II of this book. They all face the south, every room having light and air from opposite sides, and are alike with the exception of the finish. The wards have a number of windows in the rear and side walls, and are protected in front by large sliding glass and sash frames placed between the columns which can be pushed up and out of the way allowing the wards to become part of the porches. These lean-tos were built to house incipient tuberculous cases, but they are so well planned and constructed that they could be used for advanced cases. Institutions such as small town or county hospitals that need an isolated ward for advanced cases could use this building as a model, and by as toilets
deep, finished in the
ran MhN I
ARCmTECTS. J. &M. Kennedy, View of Front Ele\-ation and Floor Plan. Capacity,
No. 76.—Delaware State Sanatorium, Wilmington, Del. Society Lean-to.
Estimated Cost, $1,000. 127
dividing the wings into single rooms and using the pa\'ilion for a
comparatively small outlay.
interior finish, obtain a substantial
twenty patients and the cost
Delaware State Sanatorium, Wilmington, Del., Hebrew Society's Lean-to This is a frame building, on stone piers, covered externally with clapboards and roofed with shingles. 61 feet long by iq feet deep, having a rear extension 14 feet wide by 15 feet deep. This Httle building was erected to house a few patients of both (Illustration 76).
divided into a central sitting
wide by 18 feet deep, two small
Ohio State Sanatorium, Mt. Vernon, Ohio. F. L. Packard, Architect. Lean-to. View 77. OF Front Elevation- and Floor Plan. Capacity, 20 Patients. Estimated Cost, $6,500. (See illustration 67 for further description of this institution.) 128
" D ~
78. Georgia State Sanatorium, Alto, Ga. Scopes & Feustmann, and Walter W. Judell, Associated Architects. Design for a Leax-to. Floor Plan. Capacity, 16 Patients. Estimated Cost, $2,500. (See illustrations 4 and 65 for further description of this institution.)
feet wide by 23 feet long, for four patients each, one for men and the other for women; with a porch in front S feet wide by 23 feet long, and windows for ventilating the ward above the roof. The rear extension is divided by a solid partition into two dressing rooms, each containing four lockers, a toilet and a bath for the use of the patients. The building has a capacity for eight patients and the estimated cost is $1,000.
Georgia State Sanatorium, Alto, Ga., Lean-to, Floor Plan (lUustration
This plan was suggested for the lean-tos to be constructed at the Georgia State Sanatorium,
and was designed
of his bed.
on stone wide by
to give each patient a small private dressing
building to be 103 feet long
directly in the rear
25 feet deep, constructed of frame placed
divided into two open wards 16 feet wide by 51 feet long, a corridor 4 feet
and sixteen private dressing rooms each 5 feet wide by 3 feet deep. by 17 feet deep and containing This building was planned to have a capacity for sixteen baths, toilets and lavatories. patients, without a central sitting room, and to cost about $2,000.
51 feet long,
extension at the rear of the centre to be 23 feet wide
Ohio State Sanatorium, Mt. Vernon, Ohio, Lean-to for Incipient Patients (Illustration 77 j.
constructed of frame, placed on concrete piers, with
the exterior covered with shingles, having white trimmings.
long and 24 feet through the wings and consists of a central section, two porches
and a rear extension. It was designed after the lean-to type of structure, but has certain deviations from the usual plans which are worth considering, for it supplies all patients with individual dressing alcoves which add greatly to their comfort and are much appreciated.
central section contains a living
25 feet wide
connecting the two wings or sleeping porches, which are 60 feet long by
The rear extension has a floor plan designed in the shape of a cross (this 24 feet deep. being the unicjue feature of the building) 56 feet deep by 27 feet wide; except through the 9
^ X )(
— New Haven County State Sanatori-om, Meriden, Conn. Foote & Townsexd, Architects. Front Ele\"atiox axd Floor Plaxs. Note. — There are Two of these Buildixgs,
EACH Two Stories High, but with Slightly Differext Floor Plaxs. Estimated Cost, $5,000.
Capacity, 40 Patiexts.
is 52 feet wide by 22 feet deep, situated in the centre and extending making a break in the walls which increases the space used for windows. There are also more rooms in the rear extension than are usually planned for in lean-to structures, such as a linen closet, diet kitchen and nurses' room. The building has a capacity for tw-enty patients and the estimated cost is $6,500.
dressing room, which
out on each
—Lean-to Type of Building
New Haven County State Sanatorium, Meriden, Conn., Lean-to (Illustration There are two buildings of this design, one at Huntington, known as Building No. 79). 3, and the other at Meriden. They are of frame construction, on stone piers, covered externally and roofed with shingles, two stories high and both having a front elevation practically of the same general appearance, with slight variations in the floor plans. The first and second floors of both buildings are alike and consist of a central section, two wings and a rear extension, one being 98 feet long feet deep; the other 129 feet long
by 16 feet deep with a by 15 feet deep with a
rear extension 17 feet wide
rear extension 23 feet wide
by 24 by 15
room in the central section of one is 20 feet deep by 16 feet wide, wide by 15 feet deep. The wings of both consist of a single ward wath a capacity often patients, housed in separate cubicles 8 feet wide by 9 feet deep, for two patients, or for three, 16 feet wide by 9 feet deep. The front of the porches or feet deep.
in the other 19 feet
by canvas curtains and the rear walls pierced by windows to give The rear extensions are used as dressing rooms and contain individual
lockers, wash-bowls, toilets
of dividing the porches in order to
for forty patients at
an estimated cost
illustrate well the latest
in small units.
Catawba Sanatorium, Catawba, Va., Lean-to
one story frame building, covered with siding and roofed with shingles, on a concrete foundation, 121 feet long by 20 feet deep, through the wings.
or porches are
80. Catawba Sanatorium, Catawba, Va. Designed by Dr. Ennion G. Williams. Lean-to. View of Front Elevation and Floor Plan. Capacity, 16 Patients. Estimated Cost,
(See illustrations 17, 30
for further description of this institution.)
No. 8i.—Manitoba Sanatorium, Ninette, Manitoba, Canada. Designed by Dr. D. A. Stewart. Leax-to. \'ie\v of Front Elevation and Floor Plan. Cap.^city, 32 Patients. Estimated Cost, $8,000.
(See illustration 25 for further description of this institution.)
by 46 feet long, and the rear extension is 52 feet long by 12 feet deep. There is a sitting room 28 feet wide and 15 feet deep in the centre, with a trunk room 28 feet wide by 8 feet deep back of it. There are two dressing rooms 19 feet wide by 12 feet deep, and a small single bed ward 11 feet wide by 12 feet deep in the rear extension which is very con\'eniently arranged. The building has a capacity of sixteen patients and cost approxi20 feet wide
Manitoba Sanatorium, Ninette, Manitoba, Canada, Lean-to This building
placed on a cement foundation and stone piers, two stories high, of frame
construction, externally covered with shingles
94 feet long by 24 feet through the wings.
and trimmed with wood
20 feet wide
—Lean-to Type of Building
Patients' Quarters^ and contains a
room furnished with a large fireplace, and a toilet room fitted The wings of the building are 36 feet long by 24 feet deep, divided into open wards 36 feet long by 15 feet deep, with a corridor and three dressing rooms in their rear. Each floor is an independent unit for twelve patients and the building was constructed two stories in height in order to economize in heating, as the winters in Manitoba are very cold. There are two pavilions of the same t^^pe at this institution; the one housing women is shown in the illustration. The other, for men, has a slightly different floor plan, with only one large dressing room in the rear of the sleeping porch. The advantage claimed for this building is that the dressing rooms are closer to the patients and give them more privacy than in the usual lean-to type of structure. The cost of the building including its porportion of the heating plant, installation of plumbing, water supply and sewer connection was $8,000. long,
with lavatories and baths.
82. Edward Sanatorium, Naperville, 111. W. A. Otis and Edward H. Clark, Architects. Lean-to. View of Front Elevation and Floor Plan. C.-upacity. 10 Patients. Estimated Cost, $1,800. (See illustrations 62 and 88 for further description of this institution.)
OF Front Ele\'ation and Floor Plans. (See illu.strations 22
Edward Sanatorium, is
Estimated Cost, 84,000.
for further description of this institution.)
frame construction, on brick
Archer & Allen. Architects.
Capacity, 8 Patients.
on the exterior and roofed with
64^2 feet long by 16 feet wide, with a rear extension iSVo feet long by 11 feet wide. The front section consists of one ward and the building is illustrated to show the method of protecting its southern exposure and the means used to ventilate through the roof. It is
ward are pierced by eight windows and a door leading into the used as a dressing room and contains lavatories, toilets and lockers
walls of the
for each patient.
It has a capacity of ten patients
The Eudowood Sanatorium, Towson, Md., Garrett Pavilion or Leax-to (Illustration 83).
a frame structure raised on brick piers, covered externally wdth
stained shingles and trimmed with white paint. to receive the light
an attractive building, arranged
through open spaces, between the columns support-
by canvas curtains stretched on frames and hung on pivots attached to the posts. The front is 56 feet long by 20 feet deep and consists This opens into a rear of one large room used both for sleeping and living purposes. extension 19 feet wide by 24 feet deep, pro\dded "with eight lockers (large enough to be small private dressing rooms 3 feet wide by 5 feet deep), two toilets, two baths and four washThe building has a basins, the whole making a comfortable and convenient apartment. capacity of eight patients and cost 84,000. ing the roof, protected in stormy weather
Iowa State Sanatorium, Oakdale, is
frame construction, covered externally with
with shingles, and placed
on a stone foundation. In type it belongs to the lean-to group of buildings and was intended but the wings are divided into enclosed rooms with sleeping porches in
for incipient cases,
-^^.^.^..^>l+. No. 84.— Iowa State Sanatorium, Oakdale, la. H. F. Liebbe. Architect. Leax-to, 240 Feet Long. View of Front and Side Elevation ant) Floor Plan. Capacity, 40 Patients. Estimated Cost, S8,ooo.
(See illustrations 24, 29
and 103 135
for further description of this institution.)
Section \ front.
240 feet long by 24 feet deep.
twelve feet wide, enclosed with
and mosquitoes. It is claimed that this building has been a success, but that it should have a larger central section and a rear extension so as to give better facilities for toilets, baths and locker rooms. It has a capacity for forty patients and the cost of construction was S8,ooo. wire netting for protection against
The Municipal Sanatorium, This
N. Y., The Lean-to
a frame building on stone piers, 105 feet long by 18 feet wide, covered with shingles,
stained artistically and trimmed with white.
open porch or ward
dj^vided into three sections
two dressing rooms each 18
entrances from the porch.
front of the building consists of a long half partitions,
the view of the entire porch from either end. feet deep, containing
which do not obstruct is 42 feet wide by 10
wide by 10 feet deep, with separate
a small cellar excavated under the centre for a furnace
which heats the dressing rooms. The building has no sitting room and should be placed near an amusement pavilion or some other structure having an apartment for this purpose. Its peculiar feature
a break in the roof projection at the front in
placed to ventilate the wards or porches.
which A^dndows are
has a capacity of eighteen patients at an
estimated cost of S4400.
No. 85. Municipal Sanatorium, Otisville, N. Y. Designed by Dr. Heriiaxn M. Biggs. John B. \'ax Pelt, Architect. Lean-to. \'iew of Front Elev.^tion, and Floor Plan. Capacity, 18 Patients. Estimated Cost, 84,400. (See illustrations 14, 28, 59, 60, 94 and loi for further description of this institution.)
Association Sanatorium, Louisville, Ky. D. X. ^Iurphy & Brothee, Architects. Lean-to. \'iew of Front Elex'atiox and Floor Plan. Capacity, 12 P.a.tients. Estim.a.ted Cost, S2.750. (See illustration 99 for further description of this institution.)
Association Sanatorium, Louisville, Ky., Le.\x-to for 86).
on oak posts, and stands on a steep hillside. room 16 feet wide by 16 feet deep, with a dressing room in
struction, placed sitting
12 feet deep, containing bath feet
wide by 16 feet deep.
of its porches.
56 feet long by 36 feet wide including the porches,
It consists of a central its
rear 16 feet wide
each side of this section
a dormitory 19
one running along the entire front of the building, 9 feet wide by 56 feet long, and on the north are two each 9 feet wide by 19 feet long, one on either side of the dressing rooms. This plan supplies porches with a southern exposure for winter use,
and a northern exposure when the weather is too warm for comfort is twelve patients and it cost 82,750.
capacity of the building
North Reading State Sanatorium, North Reading, Mass., The Lean-to :ration 87). exterior
and roofed with
frame construction, placed on stone
one hundred and thirty-six
covered on the
feet along the front,
designed so that both the porches can be overlooked from the sitting room,
rhe length of the wings is fifty-eight feet on the front and sixty-seven feet on The central section :he rear and the width nineteen feet including the veranda. s
and the porches are
mgles made where the wings join the centre apartment. The sitting room is 24 feet wide Dy 18 feet deep and ^e two dressing rooms are both 10 feet wide by 18 feet deep, and :ontain shower baths, toilets
roof of the porch has a break on the
Tont for ventilation purposes, somewhat like that in the roof of the lean-to at Otisville The veranda in front of the sleeping porches also extends in front of the illustration 85). dtting room, and is a feature to be noted, as it adds materially to the floor space which :an be used in good weather.
There are four
vith other buildings for one of the :husetts.
by the State Commission
are very satisfactory except for the rear walls of
be rather low.
up in connection in Massathe porches which are
of these lean-tos, all alike, put
twenty patients and they cost $3,500 each.
No. 87.— North Reading State Sanatorium, North Reading, Mass. Johx A. Fox, Architect. Lean-to. View of Front Elevation, Floor Plan antd Cross-section. Capacity, 20 Patients. 138
— Edward Sanatorium, Naperville,
AND Edward H. Clark, Architects. C.AP.ACiTY; 6
Designed by Dr. Theodore B. Sachs. W. A. Otis View of Front Elevation and Floor Plan.
(See illustrations 62
for further description of this
Edward Sanatorium, is
frame construction, placed on cedar posts, covered externally and roofed with cedar
It is 52 feet long
wide and consists
deep and dressing room 15 feet wide by 12 feet deep, at one end, from which extends out at a right angle a porch or open ward 36 feet wide by 71 feet deep. The
wide by 10
room is plastered and has three large windows breaking up the south wall and two windows and a door leading to the porch. The dressing room is finished in the same manner and contains lockers for each patient, toilets, baths and lavatories. The porch is unfinished, faces the south, has an open front protected in bad weather by canvas curtains, a large door occupying one-half of the east wall, and two large ventilators in the It is illustrated to show the means used to ventilate the porch; the rear and side roof. walls, with the continuous row of windows and the ventilators in the roof, should be noted. The building has a capacity for six beds and cost $1,287. sitting
State Hospital, Mt. Pleasant, la. H. F. Liebbe, Architect. Lean-to. AND Floor Plan. Capacity, 12 Patients. Estimated Cost, $3,000.
Iowa State Hospital, Mount Pleasant, building
planned on the
lines of a lean-to,
section which projects to the rear.
It is a
with two wards on either side of a central
one story building
and finished in oil. The exterior is covered with cedar shingles stained dark brown and trimmed with an ivory color. In the centre of the building is a room 15 feet wide by 19 feet deep, used both as a sitting and dining room, and extending out from each side of it is a porch or open ward
interior walls are sealed with yellow pine
From the wards, on the sides of the central 37 feet long by 14 feet wid* for six patients. room, are passageways 4 feet 6 inches wide by 13 feet long, running back to the dressing room, which is 10 feet wide by 19 feet long, and contains a bath tub, three wash-bowls, a toilet
entire front of the building
the inner sides of both halls are lockers for each patient. is
open, but fitted between the pillars with sliding sash and glass
windows and frames for screens. The rear walls of the wards also have windows between each bed in order to produce cross-ventilation. The rear extension is 20 feet deep by 30 feet wide, well lighted by windows at every available point, with a cellar excavated under it, containing a hot water heating plant. In the central room is a brick fire-place and an electric oven for reheating the food sent in from the service building, before it is served to the patients. It also has windows on the front above the porch giving sunlight to the 140
—Lean-to Type of Building
ventilation near the ceiling.
cost of the building complete, constructed
was $3,000, but the capacity can be enlarged at small expense if desired, by adding rooms at the end of each ward. Attention should be called to the situation of the combination sitting and dining room, the placing of the lockers in halls on its sides and the porch space in front of the central room, used as a vestibule to the to house twelve patients,
of a floor plan for the lean-to type of building.
Hospital, Country Branch, Malvern, Pa., Lean-to
a frame building of very cheap construction, placed on concrete piers, and covered
by a composition
two stories high, 53 feet long by 12 feet deep, with a small wide by 18 feet long, enclosed for a dressing room and containing lockers, lavatories and toilets. The balance of the ground floor is used by patients for a lounging and sitting room. The second floor is an open ward housing the beds. The front of the building on both stories is boarded up from the floor four feet, and cross- ventilation is obtained by windows in the rear wall. This structure is practically a portion of the
two story shed facing the south and patients.
one of the cheapest methods of housing tuberculous an estimated cost of
It has a capacity of seven beds at
TT C ONTT'
Beookie No. 90.— Rush Hospital, Country Branch, Malvern, Pa. Lean-to. View of Front Elevation ant) Floor Plans. Capacity, Cost, $400.
Hastings, Architects. Patients. Estimated
(See illustration 97 for further description of this institution.)
OHLN WA KTE ROOF PROJECTION
Sanatorium, Liberty, N. Y. Designed by De. Herbert Maxon King. Lean-to. OF Front Elevation and Floor Plan. Capacity,. 8 Patients. Estimated Cost, Si.ooo. (See illustrations i, 72, 73 and 108 for further description of tliis institution.)
covered externally with
and has a shingled roof. It is Dr. King's latest modification of a lean-to buildand is 70 feet long by 20 feet wide, divided into an open porch 20 feet wide by 48 feet long at one end, and an enclosed apartment 20 feet wide by 21 feet long at the other. There are lockers or small private dressing rooms 3 feet wide by 5 feet deep, for each patient, toilets, baths, and a central dressing hall between the rows of lockers. The enclosed apartment is heated by a large coal stove with boiler attachment to supply hot water for toilet purposes. It has a capacity for eight patients at an estimated cost of $2,000. siding
Michigan State Sanatorium, Howell, Mich., Lean-to, Floor Plan 92).
This was a design made for a lean-to at the jMichigan State Sanatorium, but has not
building was to have been of frame, 100 feet long
25 feet deep,
with sitting room 15 feet wide by 25 feet deep in the centre, the porches to be 42 feet long by 24 feet deep, divided into an open ward with four dressing rooms in its rear; these rooms to be for
two patients each,
wide by 10 feet deep, 142
with lockers, showers,
—Lean-to Type of Building
FOR A Lean-to.
Scopes & Feustmann, Architects. Capacity, 16 Patients. Estimated Cost, $3,500. (See
Sanatorium, Howell, Mich.
tration 74 for further description of this insitution.)
central plant. The design is worth studying and would make a convenient building for a site on a side hill as there is no rear extension in the plan. The capacity is sixteen patients at an estimated cost of $3,500.
and wash-basins and heated from a
New York 93).
State Hospital, Raybrook, N. Y., Lean-to for
be constructed either of brick or frame and
wings and a rear extension.
This floor plan was designed for a lean-to at Raybrook, but has not yet been erected. will consist of a central section,
In order to make the dressing rooms in the rear extension
accessible for the patients in the wards, the wings are designed to
form an acute
The wards are on the front, forty-six feet long on the rear and thirteen feet wide opening on to a veranda nine feet wide which extends along the entire front of the building. The central sitting room is 27 feet wide by 11 feet deep and has a large, open fire-place. Behind it is a rear extension 28 feet wide by 18 feet deep, divided into a linen room, toilet room, bathroom, dressing and locker room. The plan should be noted for the arrangements made in the wards to protect the head of the beds, by a half partition which extends about three feet in the wards. The building has a capacity for sixteen patients and will cost about $3,500. angle in the rear of the building, at their junction with the central section.
fifty-four feet long
No. 93.— New York State Hospital, Raybrook, N. Y. Franklin B. Ware, Architect. Design for a Lean-to. Floor Plan. Capacity, 16 Patients. Estimated Cost, $3,500. 143
HA.v A'.s.s i^j^T /-:nrT^